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SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
NPI 1114383023
Specialist in Jacksonville, FL

Active since January 07, 2016
15255 MAX LEGGETT PKWY, 5TH FLOOR, JACKSONVILLE, FL 32218(904) 634-0640(904) 634-0203 Get Directions Write a Review

NPPES record last updated: June 13, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 13, 2023, Sep 27, 2018 (2 updates tracked since 2018).

About Southeast Orthopedic Specialists, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEAST ORTHOPEDIC SPECIALISTS, LLC (NPI 1114383023) is a healthcare organization registered as a specialist in Jacksonville, Florida and active in the NPI registry since January 2016. The organization lists Brett Puckett, President, as its authorized official.

NPPES Registry Identity

NPI1114383023
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTHEAST ORTHOPEDIC SPECIALISTS, LLC
Location Address15255 MAX LEGGETT PKWY, 5TH FLOORJacksonville, FL 32218-7273
Mailing Address6500 Bowden Rd, Suite 103Jacksonville, FL 32216-8070 · (904) 634-0640 · Fax (904) 634-0203
Phone(904) 634-0640
Fax(904) 634-0203
Organization SubpartNo
Authorized OfficialBrett PuckettPresident · (904) 634-0640
Enumeration DateJanuary 7, 2016
Last NPPES UpdateJune 13, 20232 updates tracked since enumeration
NPPES CertifiedJune 13, 2023
✔ NPI 1114383023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

15255 MAX LEGGETT PKWY, Jacksonville, FL 32218
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRANSCENDENT MULTISERVICE ASSIST, LLC
Registered Nurse (Registered Nurse First Assistant)
15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218
Duval County (904) 382-1987
DR. SUDHA RANI MUTYALA MD
Student in an Organized Health Care Education/Training Program
15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218
Duval County (904) 383-1000
MARK A LIVECCHI MD
Physical Medicine & Rehabilitation (Brain Injury Medicine)
15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218
Duval County (904) 456-8297
SHEILA COMPTON LCSW
Social Worker (Clinical)
15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218
Duval County (904) 383-1000
SOUTHEAST ORTHOPEDIC SPECIALISTS, INC
Non-Pharmacy Dispensing Site
15255 MAX LEGGETT PKWY, 5TH FLOOR
JACKSONVILLE, FL 32218
Duval County (727) 755-0693
ALFONSO DAVID MORENO GUTIERREZ M.D
Hospitalist
15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218
Duval County (773) 349-5197
DR. ERIN THOR WOLFF M.D.
Physical Medicine & Rehabilitation
15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218
Duval County (904) 456-8001
HAILEY RUTLEDGE PHARMD
Pharmacist
15255 MAX LEGGETT PKWY
JACKSONVILLE, FL 32218
Duval County (904) 244-0411

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeast Orthopedic Specialists, LLC's NPI number?

The NPI number for Southeast Orthopedic Specialists, LLC is 1114383023. It was assigned to this organization in the NPPES registry on January 7, 2016.

Where is Southeast Orthopedic Specialists, LLC located?

Southeast Orthopedic Specialists, LLC is located at 15255 Max Leggett Pkwy 5th Floor, Jacksonville, FL 32218. The listed phone number is (904) 634-0640.

What is Southeast Orthopedic Specialists, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

What insurance does Southeast Orthopedic Specialists, LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Southeast Orthopedic Specialists, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeast Orthopedic Specialists, LLC was last updated on June 13, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.